Finding your soul-therapist

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Going to see a therapist can be great, but doing it for the first time can also be daunting and difficult. Getting yourself to make an initial phone call to make an appointment is hard enough — but first you have to find someone to call. A quick Google search is bound to turn up therapists with an alphabet soup of specialties and approaches: CBT, DBT, SPS, psychoanalysis, nondirective support therapy. It’s easy to fall down a rabbit hole in trying to figure out which therapist is right for you.

But according to Christopher Muran, Associate Dean of Adelphi University’s Gordon F. Derner Institute of Psychological Studies and President of the Society for Psychotherapy Research, picking apart the differences between types of therapy actually isn’t that important.

“Traditionally, people think of three general schools: psychoanalytic, cognitive behavioral, and humanistic,” he says. And there are dozens and dozens of different subcategories within those schools. “The proliferation of all the different models out there is off the charts,” he says.

On a general level, here are the basic differences: psychoanalysis focuses on the subconscious, or, to put it another way, what goes on beneath the surface of your thoughts. Cognitive Behavioral Therapy (CBT) looks for the connection between your thoughts and your actions; it’s focused on figuring out practical strategies that can change the way your behavior drives your feelings. Finally, humanistic therapy aims to help patients connect with their emotions, and the way that they’re experiencing those emotions.

These main categories of therapy, though, subdivide and subdivide and subdivide from there. And, what’s more, most practitioners use strategies from multiple schools with their patients.

“Maybe they’re organizing it under one umbrella, but they’re using the techniques from different schools,” said Muran. “And some of the distinctions between the schools are more political than substantive.”

But research says the type of therapy you’re using is much less important than the therapist you’re seeing.

“As much as we have a million therapies, we have a million therapists who vary in their abilities,” he says. “We have a lot of data to show that maybe the most important variable is the relationship between therapist and patient.”

But research says the type of therapy you’re using is much less important than the therapist you’re seeing.

There are two main dimensions of the relationship between patient and therapist that are critical, says Muran. First, the patient has to buy into the work they are going to be doing with the therapist. That’s where the model of therapy used can actual matter a little bit, because that determines how the actual conversations are going to go.

“Are they going to want you to talk about your experiences? Are they going to want you to do homework assignments, like with CBT? Are you going to explore dreams in a psychoanalytic way? You want to know what the sessions are going to look like, and whether that makes sense to you, and if you feel like that fits with what you want from therapy,” he says.

The second dimension is a bit harder to tease out — it’s the emotional connection you have with the therapist.

“To what extent do you feel comfortable with them, or like them?” Muran says.

Those two elements are important to figure out in the first meeting with a potential therapist. Muran suggests using the first session to ask questions.

“You have to tell a little bit of your story, and then ask how they will try to help you,” he says. “Any question they can ask to help them define those dimensions goes a long way to determine if they’re going to have a good working relationship [with you].”

If you find that therapist you mesh with on your first appointment, that’s great. But it’s also okay to have consultations with a few people before you settle on someone who works for you. Many insurance companies have lists of therapists that you can browse through, and searching online for practitioners in your area is a good place to start, as well. And if you come across someone who you think you would like on a personal level — don’t necessarily rule them out if they use a technique you’re not sure about.

“While it’s still important to pick a model that makes sense to you, it’s the relationship that will overcome that,” says Muran. “The quality of the therapeutic relationship is the most consistently predictive variable of success.”